Stroke link to hip op studied

Patients who undergo total hip replacement face a high risk of stroke, British researchers warned last night.

A major study, conducted by Southampton University, has found that patients face a five times increased risk of stroke in the two weeks following surgery.

The risk is increased for both ischaemic stroke – caused by blood clots – and haemorrhagic stroke, caused by bleeding.

Patients remain at risk for the next 12 weeks, researchers reported in the journal Stroke.

The findings come from a study of some 66,000 hip replacement patients in the Netherlands. They were compared with others of the same age and sex who did not have the same operation.

Although the findings may challenge the use of antiplatelet drugs to prevent ischaemic disease, the researchers say their findings suggest these are beneficial.

The use of drugs such as aspirin before surgery cut the risk of ischaemic stroke in the six weeks after surgery by 70%, the researchers found. But they were not linked to an increased risk of haemorrhagic stroke.

Researcher Professor Cyrus Cooper said the findings backed the use of aspirin.

He said: "This research has demonstrated that there is a high risk of stroke to patients soon after having a total hip replacement and suggests that the use of soluble aspirin might be beneficial in reducing this risk.

"Normally we would have reservations about people taking aspirin everyday but our results suggest aspirin is a benefit and worthwhile to give to the patient before the surgery. The data is of huge clinical importance and shows the benefits of large cohort epidemiology studies."

He added: "The number of hip replacement procedures will rise as we live longer: on average, the rate of hip replacement has already increased by over 25% between 2000 and 2009.

"These results will hopefully help healthcare professionals to provide improved services and help people who have hip replacements manage the risk of stroke after the procedure."

Timing of Stroke in Patients Undergoing Total Hip Replacement and Matched Controls. Stroke November 12 2012.